Female Hormones and ADHD

Female Hormones and ADHD

Here I discuss a very important review paper just published this week (December 5, 2023) in the journal, Hormones and behavior, on the possible role that female hormones and their fluctuations across female reproductive life may have on ADHD symptoms, executive functioning, and comorbid mood symptoms.

The abstract of the paper I discuss is shown below:
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that exhibits striking sex differences in symptoms, prevalence, and associated problems across development. Etiological factors and mechanisms underlying these sex differencesremain one of the most understudied aspects of this disorder. The current paper seeks to provide a novel theoretical framework for understanding this phenomenon by reviewing evidence that females with ADHD may experience a “double whammy” of organizational and activational pubertal hormonal effects. We propose a novel theory of activational effects of cyclical circulating ovarian hormones on ADHD with increasing risk at times of rapid declines in estrogen. These declines may decrease executive function and trait control at two points of the cycle characterized by biphasic affective risk: (1) increases in approach/risk-taking behaviors at mid-cycle (periovulatory) and (2) increases in avoidance/negative affect perimenstrually. Low estrogen and control may then interact with increases in positive and negative affect, respectively, to increase hyperactivity-impulsivity symptoms post-ovulation and inattention symptoms perimenstrually. These interactions may be exacerbated by organizational pubertal effects on relatively overdeveloped limbic circuitry and adolescent-specific social pressures magnified in females with ADHD.


Research Discussed

Attention-deficit/hyperactivity disorder and the menstrual cycle: Theory and evidence
AG Eng, U Nirjar, AR Elkins, YJ Sizemore… - Hormones and Behavior, 2024
https://www.sciencedirect.com/science...
https://doi.org/10.1016/j.yhbeh.2023....